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ICD-10

The information contained within this section is designed to serve as a resource to help you prepare for the U.S. health care industry's change from ICD-9 to ICD-10 for medical diagnosis and inpatient procedure coding. Blue Cross and Blue Shield of Kansas encourages you to check out all of the information contained within this section as well as the helpful web links. Some of the information provided here has been developed by the Centers for Medicare and Medicaid Services (CMS), and may assist you in the transition to ICD-10. For additional details, see the cms.gov website.

Background Information

The International Classification of Diseases (ICD-10) Clinical Modifications (CM) and ICD-10 Procedure Coding Structure (PCS) are new medical code sets under HIPAA and represent a fundamental overhaul to the current ICD-9 coding system.  A federal mandate requires all HIPAA covered entities adopt ICD-10 by the compliance date of October 1, 2015.

ICD codes are used to code medical diagnoses and procedures; calculate and adjudicate coverage; compile medical statistics; assess quality of care and help manage clinical quality outcomes for patients.

The current ICD-9 codes sets are widely viewed as outdated due to their limited ability to accommodate new procedures and diagnoses.  They do not reflect advances in medical technologies nor are they descriptive enough.

ICD-10 incorporates greater specificity of codes, more clinical information contained in the codes, and updated terminology. The use of ICD-10 will improve the ability to measure health care services, enhance the ability to monitor the population's health, provide better overall data, and decrease the need for supporting documentation needed when submitting claims.

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